【作者】 刘冠峰；

【导师】 万晓刚；

【作者基本信息】 广州中医药大学 ， 中医临床基础， 2009， 硕士

【摘要】 目的:寒热不调为临床常见的病机。追溯历史,医圣张仲景,在其传世之作《伤寒论》及《金匮要略》里,早对寒热不调的的证治有详细的论及,其学术思想,对后世医家有着广泛而深远的影响。但目前针对“调和寒热”的理论研究不多见,其重点均偏向于名老中医的医案及经验总结,或重点讨论寒热错杂的类证辨析。系统总结仲景调和寒热学术思想的报告少之又少。本课题横向联系《伤寒》、《金匮》各条文,纵向上溯《内经》理论源流,下及宋元明清诸家学说。目的在于理清探讨寒热的概念及生理病理关系,提出调和寒热的概念,结合《伤寒》、《金匮》条文,总结其有效的治疗原则、治疗方法,以利于系统运用其理论有效地指导临床实践。方法:首先,探讨“和法”、“寒热”的概念,及寒热之间的生理病理关系,以明确本课题研究范围。而后复习相关理论基础,上溯《内经》,下及宋元明清诸家学说,浅论寒热辨证的源流及发展,结合“和法”及“寒热”的概念,提出调和寒热的定义。接着重点对《伤寒》、《金匮》二书中相关条文进行分析归纳,先从诊断学的辨证上理清调和寒热在仲景学说中的应用,再从寒热在六经辨证体系中的体现运用中,进一步探讨调和寒热这一治疗法则在仲景学说中的具体体现。最后总结仲景调和寒热学术思想的临床指导意义及临床应用。结论:调和寒热法旨在平调阴阳,恢复人体水火之间的生理平衡。根据辨证可分为:外寒内热、上寒下热、寒热错杂,而在辨证施治的过程中,因先后、标本、主次、缓急的不同,或先解表寒,再清里热;或先清里热,或解表寒;或清上温下;或寒热并用;或先用解表法,再用攻里法。其治疗手段则有方药、针刺、外治法等。调和寒热在《伤寒论》最为核心的六经辨证里也有不同的具体体现。后世的医家,在不同方面补充和发展了仲景的学说,并运用调和寒热法在临床应用上取得很好的疗效。更多还原

【Abstract】 Purpose:Incoordination between the cold and heat is the frequent clinical pathogenesis.Zhang Zhong-jing discussed this question particularly in this contributions "Shanghan Lun"(Treatise on Febrile Diseases Caused by Cold) and "Jingui Yaolue"(The Prescription in Golden Cabinet).His academic standpoint has been influencing the faster generation.But these are few researches on the theory of "coordnating cold and heat" now,most of them paid close attention to summarizing rhe experiences of the famous doctors of TCM.In the thesis the valid therapeutic and therapeutics were summarized,based on the theories of ’Shanghan Lun’,’JinguiYaolue’,’Nei-jing’ and the academic standpoints of the doctors of Song,Yuan,Ming and Qing periods.Through dicerning the physiological functions and pathology of the cold and heat.I hope this study helpful for the clinical practice.Method:First,I try to make sure clear the concept of "harmonizing" and "cold and heat",in order to identify my study’s circumscription.Second,review the relevant theoretical basis could be traced,"Nei-jing" and the academic standpoints of the doctors of Song,Yuan,Ming and Qing periods light on cold and heat,and the origins of dialectical development,and integration and "cold and heat" concept,put forward to reconcile the definition of "coordinating cold and heat".Third,analyze the differences between different syndromes,to induce the corresponding therapeutics.At last,summarize the significance of this theory and Clinical Application.Conclusion:To harmonize Yin and Yang is the purpose of coordinating cold and heat. According to syndrome differentiation divided into "out cold and in heat", "up cold and down heat","cold heat mixed".All diagnosis and treatment are based on an overall analysis of the illness and the patient’s condition.Sometimes relieving exterior syndrome at first,then clear heat; Sometimes clear heat at first,then relieving exterior syndrome;sometimes both of them are treated.One of these methods is used,or two of them are used together.Sometimes,one is uesd at first and another is used at last.Accrding to this theory,there are many therapeutics here,for example,prescription and acupuncture.The later doctors developed Zhang Zhong-jing’s theory.So that this theory ismore uesfull now.更多还原